15-100043 •
CITY OF r PERMITePPLICATION
Federal Way RECEIVED 041
JAN 062015 _
PERMIT NUMBER — _ c“------
= ~—EITI( OF FEDEIRMAWAY D 1,C,
CDS
SITE ADDRESS g Z tY 1 AUE $4 J c 44ct / 14/0r� SUITE/UNIT#
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#$ /
j� voc, .dam -,.,7 5.
TYPE OF PERMIT BUILDING Dit PLUMBING S MECHANICAL D DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECTEllin 1 l 'e,ii AO tll 44 liet ir>1,
PROJECT DESCRIPTION
Detailed description of work to a e- C!{ 190( 1/ 1-40 k Atli-
(4 k
be included on this permit only A 4 /r�D>� /i ,,/4 .,/(-}t CC-c�°l � JJ
NAME 240&.....:377— F171
PRIMARY PHONE
PROPERTY OWNER Path d, <:\--- ( ez-Ite- t/(i4 Y,tie,t4 24'&...'3 7( 7'1
ll
MAILING ADDRESS E-MAIL
Ill Ii• A ' iJ J . d . ef11
CITY STAT ZIP coo
NAME 1aj g GAL / -i L 400 , 4'V L J�- �D
MAILING/f/JADDRESS
f' i E-MAIL/..
CONTRACTOR 1rL6 !STi9ri/!1 f J/ AE 611f,C� 41a4er&l efJ�fiui
CITY. STATE ZIPTg-E6 0 FAX 1 ,.1"A
WA STATE/ CON�SXOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# (/�'f/I
/ / litioq 1 o
NAME - �f' '1 i i j �� PRIMARY PHONE
vs
L it�
APPLICANT MAILING ADDRESS �� ' E-MAIL
a Ir
CITY 11 STATE ZIP FAX
NAME '( PRIMARY PHONE Yr
PROJECT CONTACT I!
(The individual to receive and MAILING ADDRESS f E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME 0
PROJECT FINANCING OWNER-FINANCED
A i
Required value of$5,000 or more MAILING ADDRESS,pit /�TY,STATE,ZIP PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses, and attorneys'fees incurred in
the investigation and defense of such claim), hich may be made by any person, including the undersigned,and filed against the city,
but only where such claim arises out o e reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a of this application.
SIGNATURE: DATE 12 q '1�C11
PRINT NAME: I.411eon, Pr/12..--
Bulletin#100–January 1,2013 Page 1 of 3 k:\Handouts\Permit Application
• • 1111
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS X FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS _ REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $ 600_e5 --
Indicate how many of each type o f fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/shower Combo) LAVS(Hand Sinks) I TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS ( SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ No ❑Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application
w wilding Single fatttil
City y&Federal Way PF I L.Eermit #: 115-'100043-00-SF
Community Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253F)e835-2607 Fax:(253)835-2609 p q
Project Name: ELLINGSON
Project Address: 31006 39TH AVE SW Parcel Number: 758200 0080
Project Description: Convert unfinished room into a bathroom,add wall to living room,add can lighting.
Plumbing included.Electrical permit to be submitted seperately.(Me ,han t.c i Tti i we/
Owner Applicant Contractor Lender
DAVID L ELLINGSON WILLIAM&MARY PILTZ MASTER BUILDERS
KATHARINE J ELLINGSON MASTER BUILDERS CONSTRUCTION NW LLC
31006 39TH AVE SW CONSTRUCTION NW LLC MASTEBC903JE(5/30/16)
FEDERAL WAY WA 98023 112 SILVERNAIL ST NE 112 SILVERNAIL ST NE
ORTING WA 98360 ORTING WA 98360
S. _ ,
Census Category: 434-Residential alt/add-no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load
Floor Area(sq.ft.) 0 0 _ 0 0
Additional Permit Information
New/Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement. 0
Mechanical to be Included? No Plumbing Work Valuation 4000
Plumbing to be Included? Yes
Mechanical Fixtures
Fans 1
Plumbing Fixtures
Lavatories 2 Showers 1 Water Closets 1
PERMIT EXPIRES Sunday, July 5, 2015
Permit Issued on Tuesday, January 6, 2015
I hereby certify that the above information is co rect and that the construction on the above described property and
the occupancy and the use will be in acc nce with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: -. Date: / Age
s✓
kr
• �, . 1
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: ELLINGSON Permit#: 15-100043-00-SF
Address: 31006 39TH AVE SW
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load
Floor Area(sq.ft.) 0 0 0 0
Owner Name: DAVID L ELLINGSON
KATHARINE J ELLINGSON
Owner Name:
Owner Address: 31006 39TH AVE SW
FEDERAL WAY WA 98023
Building Official Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severly affect the health and safety of the general public. Although the City has made as complete a
review and inspection as is reasonably possible(within budgetary time and personnel limitations), the City neither guarantees nor
warrants to the owner/occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises.
•
THIS CARD IS TO MAIN ON-SITE '
C„ •
�OF C• onstruction In ection Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 15-100043-00-SF Address: 31006 39TH AVE SW
Project: DAVID L ELLINGSON FEDERAL WAY, WA 98023-2179
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as
possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your
inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
Ei SWM Precon Site Mtg(4400) El Initial Erosion Control(4365) ElFootings/Setback(4110)
Approved To be done prior to breaking ground Approved to place concrete
By Date By Date By Date
❑ Plumbing Groundwork(4190) ❑ Underfloor Framing(4285) CI Floor Sheathing(4105)
Approved to cover Approved to sheath floor Approved to install flooring
By Frit. Date (. 12,..(s'' By Date By Date
Shear Walls(4245) ❑ Roof Sheathing(4220) Rough Plumbing(4230)
Approved to install sid' Approved to install rooms Approved
By to dfr By ate A By f, ,, Date j ._ - 1
.
Fire/Draft Stops(4095) 0 Interim Erosion Control(4370) Prior to scheduling a Framing inspection;
Approved Approved Electrical,Plumbing&Mechanical Rough-in and
Byf Date • a By Date Fire/Draft Stop inspections must be signed-off and
approved. IBC 1093.4
•
Framing(4120) 'ElInsulation(4150) 0 Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By P Date (.21S , (. ' By f?Art— Date ( , Itr,(; "' By PA-L. Date Z - 2 • I-
,
Ei
•• Final Erosion Control(4375) El Final-Plumbing(4075) Final-Building(4050)
Approved Approved Approved
By Date By Date e3_3%.-t S By n \x1.-v Date s 9,1_t-s
.
CD rA2cisah„tc,t
i'Let. Doe, I a3 lr_
El Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date